Friday, May 11, 2012

Crackpot or Savior? Does It Even Matter?

A friend of mine posted on Facebook today about the book The Alcohol & Addiction Cure by Chris Prentiss. The website claims the book “contains the breakthrough three-step holistic program to total recovery.” The television commercial specifically states, “This is not a 12-step program; this works.” I used a semicolon between those two statements because the inference (for me at least) from the tone of Prentiss’ son Pax’s voice when he says it is that 12-step programs don’t work.In the comments section of my friend’s post, there were comments about selling hope to addicts and that 12-step programs have data to back up their success while this “cure” uses a very short metric to measure success. I started to respond in the comment section, but then it got a little long and I thought, “Ooooh, I could actually post this on my blog and it will count as ‘writing’.”

I’m pretty sure (without going through the tedious process of actually checking) that both the comments above are at least mostly valid. Depending on the data you use and the way you analyze it, there is proof that 12-step programs work. Unfortunately, I think you can take data and analyze it in such a way that would prove they don’t as well. The claim that Passages (the rehab center where they implement the program outlined in the book) uses short metrics to determine success is almost certainly true. Why do I think that? Well, I think that because of a direct quote from Prentiss when asked what he tells people when they leave after 60 days (the recommended length of a stay at Passages), “You’re cured. Totally. You will never use drugs and alcohol again. Your dependency has been cured. Have a wonderful life.”

Prentiss claims that his 84.4% success rate is based on the latest survey of 700 of his graduates, with whom he keeps in touch via phone or alumni gatherings. There are a couple of problems (for me) with that claim. First, Passages opened in 2001, which means that over the course of 11 years he can only “prove” he’s cured fewer than 600 people. That’s about 50 people a year. Passages charges $67,000 a month. Beyond that, there is the problem that he counts someone who has stayed sober for 30 days beyond his/her stay at Passages cured in the same way someone who has been sober for five-plus years is. And, he can only survey the people that stay in touch with him. I’m guessing the people who have gone back to their addictions aren’t checking in regularly at those alumni gatherings. All that is pretty much academic though.

Here's the thing for me. When I went to my first CMA meeting, I not only didn't think 12-step programs worked, I was adamant that they did not. I was certain the whole thing was a big cult or some sort of a religious multi-level marketing scheme. Just instead of getting people to buy/sell a product, everyone had to recruit people to be sober and get them to recruit more (turns out I was only partially wrong about that part). All the proof and data in the world didn't mean a thing to me until it worked for me. Now that it has worked for me, I believe.

However, I've never said to anyone who wasn't already giving the program a try, "I think the 12 steps would be a solution for you." What I say is, "This is what worked for me. You have to decide for yourself if it will work for you." It’s not my place to tell someone that he is an alcoholic or an addict. Unlike Randy Jackson on American Idol, I don’t get to say (much as I might like to), “For me for you dawg, those drugs are a problem. You need a program.” Part of the 12-step process is that we all decide for ourselves if we are addicts. The way we decide is by listening to others who say they’re addicts tell their stories and seeing if we identify or relate with those stories.

I've had a couple of friends who started going to meetings because they saw how it worked for me. Both of them were in the program for about a year and stopped going. Both of them seem genuinely happy with their lives and have not gone back to using substances and don't appear to be drinking alcoholically either.

I also know people who have been sober for 20-plus years that still attend meetings and work with other alcoholics/addicts to help them get sober. And I know people who have been coming to meetings for more than ten years and always seem to have less than 90 days sober.

What does it all mean? The program is a cure? The program works only as long and as well as you put in the work? It doesn’t work at all and it’s all a sham? Maybe. Maybe not.

None of this leads me to believe anything -- good or bad -- about how the program works for me. I'm an addict. I know I am because I see my addictive behavior in all areas of my life. I know that for me I can't walk away from this program and stay sober, let alone experience being what the book Alcoholics Anonymous refers to as “happy, joyous and free.” I also know that nothing anyone could teach me for 28 days or 60 days or even six months would have any lasting effect on my life.

Maybe others are different and those methods can work for them. I don't need to debunk that or be threatened by it because it will either be true or false for every person that tries it.